ArticleJournal of athletic training2024
The relationship between knee joint effusion and quadriceps strength and activation after anterior cruciate ligament (ACL) injury and reconstruction.
Article in Journal of athletic training, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Psychological Readiness and Kinesiophobia Are Not Associated With Effusion-Synovitis in Early Recovery After Anterior Cruciate Ligament Reconstruction.Journal of sport rehabilitation · 2026Article
- Muscle atrophy after ACL reconstruction involves molecular mechanisms beyond unloading.Journal of applied physiology (Bethesda, Md. : 1985) · 2026Article
- Joint effusion after anterior cruciate ligament reconstruction: Associations with higher postoperative physical activity, patella alta and increased quadriceps tension.Journal of experimental orthopaedics · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
contextKnee joint effusion and quadriceps strength and activation deficits are common consequences of anterior cruciate ligament (ACL) injury and reconstruction. The presence of an effusion may initiate or worsen the quadriceps dysfunction present after ACL trauma. In simulated effusion studies, evidence indicates an inverse relationship between effusion size and quadriceps dysfunction. While this relationship was not found in patients after ACL injury, prior research was limited by a subjective clinical assessment of effusion grade.
objectiveThe purpose of this study was to determine if the size of the knee joint effusion, measured via ultrasound, after ACL injury and reconstruction influences quadriceps strength and activation.
designDescriptive Laboratory Study.
settingResearch Laboratory. PATIENTS OR OTHER
participants41 individuals (23 females, age=21.8±7.5years, height =171.7±7.9cm, 15 mass =72.3±14.2kg), with an ACL injury reported for 2 sessions [one before 16 reconstruction and one ∽16 weeks after ACL reconstruction].
main outcome measureThree ultrasound images of the suprapatellar pouch and three trials of quadriceps strength and activation using the interpolated twitch technique were gathered from the ACL knee. Effusion cross-sectional area was measured using ImageJ, averaged and inputted into linear regression models to predict muscle strength and interpolated twitch activation. Analyses were considered significant at p≤0.05.
resultsNo relationship was found between effusion size and strength (R2 = 0.086) or activation (R2=0.056) after ACL injury (p>0.05). After reconstruction, however, there was a small negative relationship between effusion size 24 and activation (R2=0.122; Standardized β=-0.349; p=0.025), while no relationship was found for effusion size and strength (R2=0.000; p≤0.05).
conclusionsThe size of the effusion after ACL injury does not influence strength or activation. However, after ACL reconstruction, effusion size does have a small influence on quadriceps activation, with a larger effusion being related to lower activation. Prior research using simulated effusions appear to overestimate the effects of effusion on quadriceps function.
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